By Mark Binker and Nicole L. Gill
WASHINGTON – The number of new gonorrhea infections in Maryland has dropped by half in the last decade, from 24,132 cases diagnosed in 1987 to 11,318 in 1996.
While health officials cannot point to any one cause for the decline, they said it is at least partly attributable to the fear of another disease – AIDS – and the safe-sex message that has come with it.
“I really think the predominant reason for the decline [in gonorrhea cases] is the prevention effort related to AIDS,” said Arthur Thacher, Prince George’s County’s health officer.
“I believe that concern over AIDS, an abundant supply of condoms out there, and having less indiscriminate sex has had a wonderful overall benefit for all sexually transmitted diseases,” said Thacher.
But while state health department statistics show gonorrhea is definitely declining, health officials can’t say the same about AIDS.
New cases of full-blown AIDS have more than tripled in the last decade, from 508 cases logged in 1987 to 1,788 in 1996.
By contrast, Prince George’s County has cut its gonorrhea infection rate from 5,111 in 1987 to 2,039 in 1996. In fact, all but one of Maryland’s counties has cut their infection rates.
Thacher said sex education and disease prevention programs combined with aggressive diagnostic and treatment activities have served to reduce the number of new gonorrhea cases.
Health officials are quick to point out that the number of AIDS cases, while up over 10 years, actually dropped from 2,143 in 1995 to 1,788 in 1996.
Because AIDS generally takes 10 years to develop, and because the state only records full-blown cases, health officials said the statistics today really reflect infection rates of 10 years ago.
“AIDS is a late-term manifestation of high-risk activity that happened almost 10 years ago,” said Liza Solomon, head of the Maryland AIDS Administration.
She also said that AIDS rates are driven by more than just sexual activity.
“The predominant mode of transmission is injection drug use,” said Richard Kelly, head of Baltimore City’s HIV/AIDS administration.
More than half the AIDS patients in the state live in Baltimore City, where injection drug use is rampant. Kelly said that more than 60 percent of the HIV transmission in the city is via injected drug use, and that 80 percent of all cases are in some way drug related.
Another difference between the diseases is that gonorrhea can be cured. “Treating gonorrhea is also preventative … if you identify a case you can cure it and it’s no longer passed on,” Kelly said.
Gonorrhea is a bacterial infection that inflames genital and other mucous membranes and causes discharges of pus and mucous from the urinary tract.
Health officials in smaller counties also credit combined education and treatment efforts for the dramatic drop in gonorrhea cases.
Washington County Health Officer Robert Parker credits community outreach with the drop in not only gonorrhea but also syphilis and other sexually transmitted diseases.
While syphilis is on the decline in some counties, statewide there has been a small increase over the last decade. Most of this increase can be credited to Baltimore City.
Baltimore will most likely continue to be the epicenter of Maryland’s AIDS, syphilis and other sexually transmitted disease epidemics said Dr. John Zenilman, an epidemiologist with the Johns Hopkins University School of Public Health.
He also warns that while injection drug use continues to be the most prevalent form of transmission for HIV, the virus that causes AIDS, non-drug users should not become complacent.
“The most rapidly increasing group of HIV [patients] is heterosexuals,” said Zenilman.
However, he does agree that sex education and other prevention programs do seem to be having a positive effect on sexually transmitted diseases other than AIDS.
“Certainly, you have to address all the ways people get infected in order to make prevention work. … Talking about sex alone obviously won’t work to prevent AIDS,” said Solomon.